Nursing unions have published a vote of "no confidence" in the chairman, chief executive and medical director of the Western Isles health board.
A statement from Unison, the Royal College of Nursing and Amicus said they had no confidence in David Currie, Dick Manson and Dr John Smith.
NHS Western Isles is trying to deal with a £2.5m overspend.
Mr Currie said the board would go-ahead with the implementation of its 10-point action plan.
He said: "We are sorry that three of the unions have taken this stance and that they do not want their members to be at the centre of the board's planning and service delivery in the future.
"The board will meanwhile press on to implement the 10-point plan that we have drawn up."
The islands' council has already called on Health Minister Andy Kerr to intervene.